Why health facilities, professionals under attack – Enabulele
Dr. Osahon Enabulele was recently elected the president, Commonwealth Medical Association. In this interview, the former president, Nigerian Medical Association, NMA, with our correspondent DAVID LAWANI, speaks on issues that concern healthcare system in commonwealth countries.
What is the Commonwealth Medical Association, CMA, and what it means to be the new president?
The Commonwealth Medical Association has been on ground for the past 57 years but this is the first time a Nigerian is being elected the president of the association. It’s a great opportunity for a Nigerian to have a taste of the executive powers of CMA and also enjoy the good things that come from the association.
What are the core objectives of the CMA?
It is to among other things, strengthen the capacity of physicians and other health care workers to be able to contribute greatly to the strengthening of health care system in the 53 member countries of the commonwealth.
At what state did you meet CMA?
I always try not to look at the past but sometimes, you would be forced to do that to get clearer picture of next line of action. I deeply appreciate and respect my predecessors and I look forward to their support and counsel to consolidate on previous achievements.
However, I will say that there’s a lot more to be done within CMA to make it more effective. Different administrations have done their part but I need to get the world to reverberate with the signature tune of CMA. I will work hard with my team to boost visibility and significance of CMA to the global community.
It’s a huge task. How do you intend to achieve that?
It’s achievable. We will introduce some schemes that would help us achieve that and most importantly, fast-track the attainment of Universal Health Coverage (UHC) within the commonwealth nations. Attention will be more on low and middle income countries in Africa.
We would also advance advocacy that would strengthen the health right and knowledge of citizens in commonwealth countries. In addition to that, we would meet with government of such countries and share our ideas with them and beg for support. We believe that only healthy people can work and contribute to the socioeconomic and political development.
Will the responsibilities of this office not be too much for you?
Not at all. CMA was established 57 years ago and it was people that built it to this point. Undoubtedly, I have the capacity to run the affairs of the office effectively and possibly perform beyond expectations.
I have been vice president of CMA for two tenures of three years each. So I am very conversant with CMA. In addition to that, I have had consistent engagement at both CMA and other global platforms for over 14 years. So I have the requisite experience and knowledge of the issues. But most importantly, I have my vision, mission and other ways that I had designed to achieve success in my three year tenure as CMA president.
You talked about safe hospital initiatives during your acceptance speech. What do you mean by that?
It’s an initiative to address violence against physicians and other health workers in hospitals. Violence against health workers and physicians is an increasing phenomenon globally particularly in locations with security challenges.
Safe hospital initiative was designed to ensure regular violence audit in the health facilities, ensure proactive measures to reduce violence and also strengthen communications between healthcare providers and patients. Poor patients understanding of working conditions of the healthcare system and several other factors could be responsible for the rise in violence against health facilities and its workers.
It’s a strong disincentive for provision of healthcare services. Professional misconduct or negligence could also lead to violence especially when a patient had lost a family member or loved one. It could be devastating and frustrating.
You promised to establish young doctors’ forum, what purpose will that serve?
It’s a very important platform to interact with younger physicians. Besides, any organisation that does not promote or guide its younger ones will, undoubtedly, face human resource crisis. Another reason for the forum is for seamless generational shift in the profession in a way that people behind are properly groomed, mentored and placed on the part of professional excellence.
World Medical Association, WMA, recently raised a concern that younger medical doctors lack in certain skills to relate with patients.
It could be true, but it was not so in the past and that’s why we need to ask ourselves questions. The world health system and the profession is now advocating patients centered care. The Nigeria Medical Association just concluded its 2nd annual health summit few days ago in Abuja, and the focus was on patients centered care.
It was an avenue to reflect on relational elements where physicians are in tune with the emotional, psychological realities of the patients beyond the biological. It allow patients to be involved in decision making as against the old practice of doctors taking decisions alone. The young doctors’ forum is a comprehensive platform for younger doctors to build their capacity and be better in the profession.
Every doctor, irrespective of specialty needs to be thoroughly grounded in patients centered care to have effective result. I will suggest that it be included in basic undergraduate curriculum of would-be medical professionals so they can be taught at the level. There’s also a need for programmes in family medicine at the undergraduate level for better understanding of patients centered care.
There is also a system issues particularly in public health care system that need to be addressed to enhance the productivity of doctors and other healthcare workers.
Are you comfortable with the state of Nigeria healthcare system?
Obviously not. There is urgent need for increased investment to improve healthcare delivery system in Nigeria. In addition to that, the system needs quality and dedicated manpower as well as modern facilities that would reduce financial pressure being faced by patients.
National Health Insurance Scheme is a very good example. It was established in 2005 to take the pain out of patients. But from all indication, the scheme has failed Nigerians and people that established it due to massive corruption, maladministration, and several other factors.
Effective and efficient NHIS would have helped to accelerate UHC. Nevertheless, I have just taken office as CMA President. The first few things I will do is carry out a holistic rating of healthcare systems in CMA member countries. Thereafter, I can boldly categorise health care services in commonwealth countries and take actions where necessary.
Of what benefit is your CMA presidency to Nigeria’s healthcare system?
Lot of privileges for Nigeria from CMA’s rich resources particularly in technical knowledge and expertise. UHC is the language of the world today which, basically, is to ensure that larger percentage of world population have access to quality and affordable health care services that should not expose them to unnecessary financial risk. We would, undoubtedly, offer great help to Nigeria and other countries to advance their health care systems.
Are you worried about the brain drain phenomenon in Nigeria?
I am worried just like every other person. Regrettably, the situation has assumed worrisome dimension. Nigeria is facing a huge brain drain phenomenon in very monstrous proportions. It’s a cause for concern.
One of my first steps would be to rank health care systems in commonwealth countries to ascertain their state. We would, thereafter, institute CMA excellence award both for countries, individual physicians and health workers who have performed excellently well in their professional engagement.